This career development award aims to provide the foundations for the candidate's career transition to an independent researcher and leader in health services research and policy focusing on the intersection of health care services and policies for adolescents with special health care needs. His long-term goal is to improve the health and quality of health care for adolescents with chronic conditions. From a background in pediatrics and public health/maternal and child health and his current position as a fellow in health services research the candidate has begun to develop the knowledge-base and skills necessary for a successful career in health services research. This award proposal details a 3-year scope of work through which he will gain the theoretical and methodological knowledge and skills and research experience that will serve as the foundation for future research endeavors. Specifically, the 3 year goals of this proposal are to: 1) acquire expertise in research methodology through the completion of doctoral training in health services research; 2) conduct a series of substantively related research studies under the mentorship of a team of experienced interdisciplinary health services researchers utilizing a variety of research methodologies; 3) build a network of colleagues and collaborators within the University of Minnesota as well as nationally through participation at local and national seminars and meetings; and 4) prepare and submit two federal research grants based upon the findings from the mentored research. The three related research projects that comprise this application address the issue of improving the quality of care provided to adolescents and young adults with special health care needs as they transition to adulthood and from pediatrics to adult oriented health care. The specific aims are: 1) to compare delays in care and unmet needs and their determinants between adolescents (14-17 years) and young adults (18-24 years) with chronic conditions utilizing data from the National Health Interview Survey (NHIS); 2) to compare the factors associated with access to health care, and specifically primary care services between adolescents and young adults with chronic conditions utilizing data from the Medical Expenditures Panel Survey (MEPS); and 3) to compare the health care utilization and expenditures between adolescents and young adults with chronic conditions and to evaluate the effect of loss of insurance coverage on health care access, utilization and expenditures utilizing MEPS data. [unreadable] [unreadable] [unreadable]